Effect of Pneumococcal Conjugate 13 Valent and Polysaccharide 23 Valent Vaccination on Anti-Pneumococcal Antibody Titer of Hemodialysis Patients: A Randomized Clinical Trial.

Background: Pneumococcal infections are a life- threatening disease in hemodialysis patients and vaccination against pneumococcus is an effective prevention. The current study aims to evaluate the immune response and maintenance of the anti-pneumococcal antibody titer in hemodialysis patients to the 23 valent pneumococcal polysaccharide vaccine alone and 13 valent conjugated with 23 valent polysaccharide vaccine. Materials and Methods: This study is a randomized clinical trial that was performed at Loghman Hakim Hospital in Tehran, Iran in 2017. A total of 70 patients undergoing hemodialysis were randomly assigned to intervention (22 patients) and control (23 patients). In the control group, only one dose of the PPSV23 vaccine while patients in the intervention group were injected initially with PCV13, and then after at least 8 weeks PPSV23 vaccine. The outcome of this study is first and sixth-month antibody titer after injection of the PPSV23 vaccine. Results: The obtained result showed no significant difference between the two groups in the first month and sixth months. The results indicate that both the intervention group (treated with PCV13+PPSV23) and the control group (treated with PPSV23 only) experienced a significant impact from the first to the sixth month. Additionally, there was a noticeable effect on the levels of anti pneumococcal antibodies during the first to sixth month between the intervention and control groups. In addition, the difference between the antibody titer of the first month and the sixth month was not significant in the two groups. Conclusion: The anti-pneumococcal antibody titer in hemodialysis patients does not show a clear difference after two vaccine injections and one vaccination.

Influence of synthesis parameters on the optical and photocatalytic properties of solvo/hydrothermal CuS and ZnS nanoparticles.

Copper sulfide and zinc sulfide nanostructures were synthesized using a solvo/hydrothermal method and a thio Schiff base ligand, N-benzylidene ethanethioamide, as a source of sulfide ions. The effects of different synthesis parameters including the type of solvent, temperature, and duration of reactions on the morphology of the CuS and ZnS products were investigated using field emission scanning microscopy and transmission electron microscopy, respectively. The structural aspects of the samples were characterized using powder X-ray diffraction, Fourier transform infrared spectroscopy, and energy dispersive X-ray analysis. The optical properties of the samples were studied through their optical absorption and photoluminescence spectra. The photocatalytic ability of the as-synthesized sulfides was explored by studying the colour removal of methylene blue under ultraviolet light irradiation.

Systemic Fibrinolytic Therapy in the Presence of Absolute Contraindication; a Case Series.

In massive pulmonary embolism (PE), fibrinolytic therapy is a potential lifesaving treatment; therefore, if other treatments are not available, the physicians encounter this question: can we accept the risk of complications from fibrinolytic therapy, especially intracranial hemorrhage, in the presence of absolute contraindication, in order to save the patient's life? Here, we describe three cases of massive PE with absolute contraindication for fibrinolytic therapy who presented to emergency department following dyspnea. Since, surgical or catheter embolectomy were not available and patients were very high risk for transferring to another hospital, systemic fibrinolytic was administered. The patients improved clinically and were discharged from hospital. It seems that, if no other acceptable treatments are available, physicians could consider fibrinolytic therapy, even at the presence of contraindication, to save the patient's life.